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C I T Y O F <br />INCVAKES <br />Business Name: <br />Property Address: <br />Community Development <br />Interim Administrative Permit Application <br />Outdoor Dining <br />Will Alcohol Be Served in the Outdoor Dining Area? <br />❑ No ❑ Yes* <br />*If Yes, please contact Lisa Hogstad-Osterhues, Deputy City Clerk at 651-982-2424 to discuss Liquor <br />License Requirements <br />Please note: In signing this application, I hereby acknowledge that I have read and fully understand the <br />applicable provisions of the State Regulations, City Ordinances and current COVID-19 policies. All <br />interim administrative permits must comply with the requirements for that use as established by the <br />Zoning Ordinance, and must be conducted or located on sites that are property zoned for such uses. <br />Applicant Name: <br />Signature: <br />Phone: <br />Address: <br />Cell: <br />City: <br />State: <br />Zip: <br />Fax: <br />E-mail: <br />Property Owner Name (if different than applicant): <br />Signature: <br />Phone: <br />Address: <br />Cell: <br />City: <br />State: <br />Zip: <br />Fax: <br />E-mail: <br />Permit Fee: $0 (Fees have been waived for the Interim Administrative Permit Application) <br />FIRE DIVISION APPROVAL: <br />PLANNING APPROVAL: <br />BUILDING APPROVAL: <br />CITY CLERK/DEPUTY APPROVAL*: <br />*Approval required if alcohol will be served outside <br />PERMIT # <br />DATE: <br />DATE: <br />DATE: <br />DATE: <br />1 <br />